Most of us have the need to do something exceptional—to be special. This compulsion has always been a catalyst for human exploration and advancement. We want our lives to matter. I have met many people who experience a crisis if this need goes unfulfilled, if they believe they can’t contribute anything of value to the world.

As someone who has struggled with depression for most of my adult life, I finally understand that my illness has been all about self-hate, about the loss of my personal dignity. I used to have goals and ambitions, but they suddenly vanished, and I told myself I had failed.

Thoughts of being a total loser were always pressing, and I often felt my family would be better off without me. Now I realize these kinds of thoughts are at the very heart of the illness. Every clinically depressed person I’ve met has felt this way. It doesn’t matter how often we hear that we are loved. We don’t feel it—or believe it.

When I was in the throes of the illness, fatigue, hopelessness, and physical pain constantly reinforced this belief. No one could fix me. The train had left the station, and the world had continued on without me.

In my memoir, I write, “Depression [has] to be the only illness that [strips] its victims of any desire to get better.” At rock bottom, we are the living dead to some extent, without any self-respect.

Of course, such thinking is a huge challenge for friends and family members. A man once told me how frustrating it was to be the friend of someone who struggled with long-term depression.

“He’s so selfish,” he told me. “He never wants to do anything I suggest or even be there for his own children.”

“Let me ask you something,” I said. “How did you feel the last time you had the stomach flu and you were vomiting all over the bathroom floor? Would you have been able to go to the movies or attend a parent-teacher conference?”

“That’s different. His depression has gone on for years, and the flu wouldn’t last that long.”

“Would your view change if your friend was diagnosed with cancer?”

He paused. “I’ll have to think about that.”

“Be there outside the bathroom door,” I said. “Tell him you understand he is in pain, and that you’re there for him when he’s ready.”

It’s important for loved ones to understand that those of us with a mental illness are struggling with a difficult medical condition. When we aren’t judged, glimpses of self-awareness can occur over time.

Now sixteen years after I was diagnosed, I feel that life is finally manageable, and my dignity is slowly returning. It has been a long and hard road, but I believe that empathy is what I needed the most. Today I focus on giving it to others.